Erectile Dysfunction: Symptoms and Causes

Erectile dysfunction is caused by a number of physical, emotional, and lifestyle factors, including cardiovascular disease, diabetes, high blood pressure, depression, and excessive alcohol use. Symptoms of erectile dysfunction include difficulty getting and keeping an erection that is hard enough for your sex life.

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What is ED? | How do erections occur | ED Causes | ED Symptoms | Treatments

Erectile dysfunction is an incredibly common problem across the world that is estimated to affect up to 50 percent of men at some point during their lifetime. Despite how common the condition is, it remains a taboo subject for many people as men deal with shame and embarrassment about their condition. 

Fortunately, there are many effective treatment options for erectile dysfunction once you understand the symptoms and causes. 

What is erectile dysfunction?

Erectile dysfunction is a medical condition that is characterized by the difficulty or inability to get or keep an erection that is hard enough to have sexual intercourse. 

Sometimes referred to as male impotence, the condition is very common, with an estimated 50 percent of men experiencing erectile dysfunction at some point in their lifetime. 

Occasionally experiencing erectile dysfunction is also extremely common, with many men having difficulty getting or keeping an erection during stressful times in their lives. 

Getting and keeping an erection requires the brain, hormones, and vascular system to work together, so erectile dysfunction can also be an indicator of physical, mental, or emotional health problems that need to be treated by a trained professional. 

Sometimes, the condition can be the first symptom of a serious health problem.

How do erections occur?

Erections are the end result of a complex chain of reactions in the body. 

When a man is sexually stimulated, the body stimulates the release of a chemical called cGMP. This chemical directs the muscles in the penis to relax, which allows blood to flow in. The amount of blood in an erect penis is approximately eight times the amount of blood in a flaccid penis, and when the blood gets trapped, it causes an erection. 

In men without erectile dysfunction, the body keeps the penis erect until orgasm is achieved or the sexual stimulation disappears. Then, it releases a chemical called PDE-5 that causes the cGMP to break down, allowing the blood flow to occur out of the penis. 

In short, the body needs the heart, blood vessels, nerves, mood, and hormones to all work together seamlessly to cause an erection. When any one of these factors is not functioning as it should, erectile dysfunction can occur.

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Erectile Dysfunction Causes

The mechanisms surrounding an erection are complex, so if any part of the process is disrupted, erectile dysfunction can occur. Causes of erectile dysfunction primarily fall into one of three categories: physical, emotional, and lifestyle causes.

Physical causes of erectile dysfunction include medical conditions that affect your body’s ability to get or keep an erection hard enough for sex. 

Physical causes of erectile dysfunction include:

The five most common causes of erectile dysfunction are atherosclerosis (clogged arteries), high blood pressure, high cholesterol, diabetes, and obesity. 

Emotional and mental health is an important component of being able to get and keep an erection. Common emotional and mental causes of erectile dysfunction include:

  • Stress
  • Guilt
  • Depression
  • Fear of intimacy
  • Anxiety
  • Relationship problems

A man’s lifestyle also plays an important role in achieving an erection. Lifestyle factors not only contribute to your overall health which plays a key role in your ability to get and keep an erection, they also can directly cause erectile dysfunction by disrupting certain hormones and body functions that are needed to achieve erection. 

Lifestyle causes of erectile dysfunction include:

  • Use of illegal drugs
  • Excessive alcohol consumption
  • Inactive lifestyle
  • Use of tobacco products

The use of certain prescriptions and over the counter medications can also cause or contribute to erectile dysfunction. 

Types of medications known to contribute to erectile dysfunction include:

  • Blood pressure medications
  • Drugs that act on the central nervous system, including some sleeping pills and amphetamines
  • Anxiety medications
  • Heart medications such as digoxin
  • Some diuretics
  • Prostate treatment drugs
  • Anticholinergics
  • Hormone drugs
  • Antidepressants, including monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), and tricyclic antidepressants
  • Opioid painkillers
  • Some cancer drugs, including chemotherapeutic agents
  • Cimetidine, a peptic ulcer medication

Most men experience erectile dysfunction as a result of physical factors. Erectile dysfunction is usually a secondary symptom of other health conditions, rather than improper function or structural issues with the penis itself. 

Erectile Dysfunction Symptoms

Erectile dysfunction occurs on a spectrum and can manifest itself in different ways with different men. The primary symptoms associated with erectile dysfunction include:

  • Persistent difficulty getting an erection
  • Persistent difficulty keeping an erection
  • Reduced sexual desire

However, early signs of erectile dysfunction may also occur, such as premature or delayed ejaculation, noticeable change in morning erections, and other sexual problems. Because erectile dysfunction is often a sign of other underlying medical problems, it is important to speak to your family doctor if you notice any consistent changes in your sexual function.

Erectile Dysfunction Treatments

Erectile dysfunction has many possible causes, which has made the condition notoriously difficult to treat. There are a number of different treatment options available depending on the cause or causes of the condition in each patient.

Prescription Drugs

It wasn’t until the approval of Viagra (sildenafil) for the treatment of erectile dysfunction in 1998 that men had an effective oral prescription medication option for the condition. 

Since the release of Viagra in the late 1990s, several other medications have been approved to treat the condition, including Cialis (tadalafil), Levitra (vardenafil), and Stendra (avanafil). 

Most, but not all, men find that the use of one of these prescription medications is effective in treating their erectile dysfunction. Oral medications are the most popular prescription treatment option for erectile dysfunction.

Another prescription medication, known as alprostadil, can be used for the treatment of erectile dysfunction. The medication is administered as a penile suppository or can be injected into the base or side of the penis.

If you experience any side effects or suffer from anything that could raise your risk factor, seek medical advice from your healthcare provider.

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Lifestyle Changes

Among the most important aspects of any erectile dysfunction treatment program is lifestyle changes. Erectile dysfunction is commonly linked to unhealthy lifestyle habits or choices including smoking, maintaining an unhealthy weight, inactivity, excessive alcohol use, and illegal drug use. 

Living a healthier lifestyle will improve your physical health, which is known to contribute significantly to erectile dysfunction for many patients. 

Suggested lifestyle changes that may help patients overcome or prevent erectile dysfunction include:

  • Quitting smoking
  • Incorporating more exercise into your daily routine (30 minutes of moderate exercise, 5 days per week)
  • Reducing or eliminating alcohol consumption
  • Maintaining a healthy weight
  • Stopping the use of illegal drugs

Talk Therapy

If psychological issues are believed to play a role in the development in a specific patient’s erectile dysfunction, talk therapy may help. 

Men who experience erectile dysfunction as a result of stress, anxiety, depression, or post-traumatic stress disorder (PTSD) may be able to discuss their feelings surrounding sex, relationship problems, and other conflicts over the source of several sessions with a licensed mental health professional. 

Erectile dysfunction can affect the dynamic of your romantic relationships, and a therapist may also be able to help you and your partner reconnect. Discussions can be geared toward psychological problems such as performance anxiety and low self-esteem that causes sexual dysfunction and deminishes sex drive. 

Erectile Dysfunction Exercises

Some men experience erectile dysfunction due to weakness in the muscles of the pelvic floor, especially older men. 

While most people don’t spend a lot of time thinking about their pelvic floor muscles, this group of muscles deep in the pelvis plays an important role in urinary function and achieving erection. 

Studies have shown that men who perform pelvic floor exercises in conjunction with making lifestyle changes saw significantly more improvement in their penile function after three months of treatment than men who only made lifestyle changes. 

Kegel exercises are the most commonly recommended exercise for erectile dysfunction. To identify the muscles in your pelvic floor and understand the sensation, stop urinating midstream the next time you go to the bathroom. The muscles that you feel engage to stop the flow of urine are the pelvic floor muscles. 

To perform a kegel exercise, contract your pelvic floor muscles and hold the contraction for three to five seconds. Then relax the muscles. Repeat this exercise 10 to 20 times in a row, working up to three sessions per day. Kegel exercises can be performed while lying down, sitting, or standing up, but they are often easier to do while lying down while you’re building your strength.


Erectile dysfunction is most commonly caused by a combination of physical, emotional, and lifestyle factors. Patients may experience symptoms that range in severity but typically include difficulty getting or keeping an erection and a loss of desire for sexual activity. 

There are many effective ways to treat and prevent erectile dysfunction, including prescription medications purchased at a discount through, pelvic floor exercises, and lifestyle changes.

References, Studies and Sources: 

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